In this commentary, we review our experience with early glottic carcinomas in an attempt to identify points to consider when developing a treatment protocol and technical considerations in oncologic resection to maintain laryngeal function. We highlight several consistent themes: (1) difficult exposure is not always a contraindication to endoscopic resection; (2) depth of invasion may be apparent only intraoperatively; (3) radiation therapy should be offered for deeply invasive cancers requiring extensive cordectomy or for patients who cannot afford lengthy vocal downtime; however, (4) radiation therapy leads to acute dysphagia and collateral damage to the contralateral vocal fold that is avoided with surgery; (5) good voice can be obtained after healing if resection is limited to intramuscular cordectomy; (6) the key to optimal vocal results is adequate glottal closure; and (7) second look operations are occasionally necessary, and therefore preoperative counseling should include this possibility...

BACKGROUND: The prevalence of morbid obesity in the United States has been steadily increasing, and there is an established relationship between obesity and the risk of developing certain cancers. Patients who have undergone prior gastric bypass (GB) and present with newly diagnosed esophageal cancer represent a new and challenging cohort for surgical resection of their disease. We present our case series of consecutive patients with previous GB who underwent minimally invasive esophagectomy (MIE)...

In the past few decades more and more number of tumors of the glottis and supraglottis are been treated with single stage transoral laser microsurgery (TOLS). TOLS for the treatment of glottic and supraglottic carcinoma with anterior commissure (A-com) and/paraglottic space involvement is associated with a high rate of recurrence. We prospectively evaluated the outcomes of laser microsurgery and the impact of second look operation in these patients. Twenty-three patients with glottic and supraglottic carcinoma underwent transoral laser micro resection of the lesions...

OBJECTIVES/HYPOTHESIS: The impact of margin status on the outcomes of early glottic cancer after endoscopic resection is controversial; second look laryngoscopy has shown a low rate of residual cancer, even in margin positive patients. Intraoperative frozen section analysis has been suggested as an alternative to routine second look procedures. The aim of this study was to evaluate and search for predictors of outcomes in patients following endoscopic resection based on intraoperative frozen section margin analysis...

CONCLUSIONS: The presented concept of second-look microlaryngoscopy in patients treated with transoral laser surgery (TLS) for early glottic carcinoma is promising and warrants further studies to evaluate its benefits. OBJECTIVES: Clear surgical margins at the primary site influence the course of the disease in patients with laryngeal carcinoma who undergo TLS. Several factors may lead to a reduced sensitivity in detecting tumor remnants at the time of the initial procedure...

OBJECTIVES/HYPOTHESIS: Transoral laser microsurgery for the treatment of glottic carcinoma with anterior commissure (A-com) involvement is associated with a high rate of recurrence. We prospectively evaluated the outcomes of laser microsurgery and the efficacy of second-look operation in these patients. STUDY DESIGN: Prospective evaluation. METHODS: Twenty-seven patients with glottic carcinomas involving the A-com underwent transoral laser microresection...

PURPOSE: The development of second primary tumors (SPTs) is the most important factor determining the survival in early-stage head and neck cancer patients, whose first tumor has been successfully treated. New methods of examining genetic changes have raised doubts about the validity of the widely held field cancerization hypothesis as the cause of SPTs, and an alternative hypothesis of monoclonal origin has been proposed. The objectives of this study were to look at the pattern of development of SPTs and the possible factors influencing the incidence of SPTs and the survival in early-stage laryngeal cancer with long-term follow-up...

BACKGROUND: Glutathione S-transferases (GST) are known to play a role in the detoxification of carcinogens. Individual isoenzymes of the alpha-, mu-, and pi-class vary in substrate specificities, tissue distribution, and activities among individuals. GST-pi expression has been shown to be increased in preneoplastic and neoplastic lesions. GST-mu is known to play a role in detoxification of epoxides released from cigarette smoke, and individuals with low GST-mu activity have a relatively high risk to develop smoking-related lung and laryngeal cancer...

The authors observe an increasing incidence of multiple primary neoplasms in the upper aerodigestive tract. Out of 1231 patients with neoplasms, 110 (= 8.9%) developed another tumour. Following oral cavity tumours the incidence of second tumours was twice as high as in other localities. Privileged site of second tumours following cancer of the larynx is the lung, after oral cavity neoplasms the hypopharynx and larynx. The mean interval between first and secondary neoplasms was 4.4 years. In tumour follow-up therapy it is recommended to look not only for relapses and metastases but also for second tumours...

Vital statistics were examined for the years 1955 through 1985 for Japanese natives and United States whites to elucidate changes in cancer mortality and related antecedent patterns of life-style in these two populations. Results show that lung cancer rates are rapidly accelerating among Japanese males as a consequence of their prior history of heavy cigarette smoking. Oropharyngeal cancer rates are also rising in Japan paralleling increases in alcohol and tobacco utilization. As the Japanese life-style and diet continue to become more "westernized," the rates of malignancies of the breast, ovary, corpus uteri, prostate, pancreas, and colon also continue to rise...

During a retrospective case-control study of recent laryngeal cancer patients, several associated factors were studied to determine possible changes in the epidemiology of laryngeal cancer between 1956 and 1974. The large sex difference noted in the early survey (male: female ratio of 14.9:1) diminished considerably in the present sample (4.6:1) because more women are cigarette smokers in the cancer age group today than was the case 20 years ago. Laryngeal cancer patients tended to be less educated than the controls and included a smaller proportion of Jews and more Catholics than the control group...